convenient care models

1. convenient care models 3/25/2014 Amer Kaissi, Ph.D.

2. Outline • Convenient care • Retail clinics • Other convenient care models • Future

3. "There's a place where ancient animals are roaming around near extinction. They are completely clueless about their future fate. Then there is Jurassic Park."

4. 61% of primary care physician offices do not have an arrangement where patients could be seen after hours Schoen et al. (2009)

5. 68% of emergency room visits are neither “immediate” nor “emergent” in nature Cunnigham (2011)

6. Government Accountability Office (2009)

7. 46,000 expected primary care physician shortage by 2025 Bodenheimer (2012)

8. Convenient Care • Care that is cheap, effective, and delivered in more convenient settings than traditional physician offices

9. Disruptive Innovations

10. Outline 10 • Convenient care • Retail clinics • Other convenient care models • Future

11. Retail Clinics • Walk-in clinics located in grocery stores, drugstores and general merchandise retailers • Care is usually delivered by a Nurse Practitioner or Physician Assistant • Up-front menu-style pricing

17. Cost per visit Emergency room $570 Urgent care Physician office Retail clinicl $103 $106 $66 Mehrotra et al. (2012)

18. Quality scores Mehrotra et al. (2009)

19. Net Promoter Score

21. 2013 Consumer Survey-RC

22. “What would you have done today if the retail clinic was not an available option?” Wang et al. (2012) 22

23. 61% of patients that visit a retail clinic indicate that they don’t have a primary care physician Mehrotra et al. (2012)

24. Outline 24 24 • Convenient care • Retail clinics • Other convenient care models • Future

25. Outline 25 25 • Convenient care • Retail clinics • Other convenient care models • Future

26. Urgent Care Centers • Usually free-standing • At least one MD is present at the clinic all the time • Care is typically delivered by MD+ NP or PA • Can treat serious conditions such as sprains, strains, lacerations, contusions, fractures

29. 2013 Consumer Survey- UCC

30. Online Health Services • 24/7 access to provider • Minor medical conditions • Answer questions based on algorithm/protocol • E-mail/text/video communication • Low fee

32. Example: Hello Health

33. House Call Services • Provider visits home/work on evenings and weekends • Contracts with employers/ insurance companies • Annual membership + low visit fee

36. Outline 36 36 • Convenient care • Retail clinics • Other convenient care models • Future

37. “Prediction is very hard, especially about the future” Yogi Berra

38. Predictions 38 38 • Increased utilization • New models

43. Predictions 43 43 43 A two-tiered health care system: • Basic primary care delivered by NP/PA in convenient locations/ways • Complex primary care & specialty care delivered by MDs in more traditional locations

44. ‘Flipping’ Health Care: Retail Clinics and Other Convenient Care Models Amer Kaissi 44